MEDICARE: ALLEN MANSFIELD DENNISON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD 06104	RI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	110113980	OTHER	RI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	04-00518	OTHER	RI	UNITED HEALTH CARE
2	3822	OTHER	RI	NEIGHBORHOOD HEALTH
3	406137	OTHER	RI	TUFTS HEALTH PLAN
4	0000000303	OTHER	RI	B/S
5	697704	OTHER	RI	HARVARD PILGRIM HEALTH
6	000630	OTHER	RI	BCHIP
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356342323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLEN MANSFIELD DENNISON M.D.

Provider Business Mailing Address
First Line	:	1180 HOPE ST
Second Line	:
City	:	BRISTOL
State	:	RI
Zip	:	02809-1126
Country	:	US
Telephone Number	:	401-253-8900
Fax Number	:	401-253-3131

Provider Business Practice Location Address
First Line	:	286 MAPLE AVE
Second Line	:
City	:	BARRINGTON
State	:	RI
Zip	:	02806-3437
Country	:	US
Telephone Number	:	404-247-0610
Fax Number	:	401-245-7362

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	07/10/2012

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Directions to “ ALLEN MANSFIELD DENNISON M.D.” Practice Location

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